What you need to know about Tulare County's suicide rate, which bucks the national trend

This May 13, 2004 photo shows designer Kate Spade during an interview in New York. Law enforcement officials say Tuesday, June 5, 2018, that New York fashion designer Kate Spade has been found dead in her apartment in an apparent suicide. (AP Photo/Bebeto Matthews, File) ORG XMIT: NYET203(Photo: Bebeto Matthews, AP)

Fashion designer Kate Spade’s death this week has reminded Americans of the enormous toll suicide takes, a growing problem that claims nearly 45,000 lives a year.

Suicide rates in the U.S. have risen nearly 30 percent since 1999, according to a report released Thursday from the Centers for Disease Control and Prevention. Suicides increased in both men and women, in all ethnic groups and in both urban and rural areas.

Suicide and “self-harm,” a category that includes attempted suicides, cost the nation $70 billion a year in medical care and lost work time, the CDC reported.

“It’s not surprising,” said Noah Whitaker, director of the Tulare and Kings Counties Suicide Prevention Task Force. “This has been carefully communicated for a long time.”

But, Tulare County bucks the national trend, while California falls a little behind.

California’s suicide rate, over the same period covered by the CDC report, is 14 percent higher. States with a similar increase are Arizona, New Mexico and Nebraska.

States such as Utah, Idaho, Wyoming, Montana, the Dakotas, Kansas and Oklahoma reported an increase between 38 and 58 percent, the highest rates reported.

Nevada is the lone state reporting a decrease.

The number of suicides in Tulare County has been flat over the last five years. So far this year, there have been eight reported suicides — half were reported in May.

Whitaker said the local task force works closely with the coroner’s office, getting a call when there’s a suspected suicide. They often report to the scene to help offer resources.

“Our goal is to support those most deeply affected,” he said.

In addition, the task force has built connections with local mental health providers, providing information, Whitaker said.

“We have done a tremendous amount of work,” he said.

County officials reported there were 40 suicides in 2005. Last year, there were 45, a decrease of three from 2016.

Graph showing Tulare County suicide rate(Photo: Submitted)

Nearly half of people who died by suicide had a known mental health condition, according to the CDC.

Family members have given different accounts of Spade’s struggle.

In media interviews, her sister, Reta Saffo, has said that she believes the designer suffered from bipolar disorder, also known as manic depression. The designer’s husband said in a statement that she “suffered from depression and anxiety for many years” and “was actively seeking help” before she died on Tuesday.

Regardless of the exact diagnosis, it seems that Spade was among the millions of Americans suffering from serious mental illness, said Dr. Jeffrey Lieberman, a professor of psychiatry at Columbia University, who has no personal knowledge of the case.

The country needs to take suicide and mental illness more seriously, said Lieberman, noting that both depression and bipolar disorder can be treated successfully, and that suicide is often preventable.

People suffering from serious mental illness are at high risk of suicide, said Dr. Jennifer Payne, director of the Women's Mood Disorders Center at Johns Hopkins Hospital.

About 10 percent of people with major depression die of suicide. About 15% of people with bipolar disorder die from suicide.

Mental illness generally first appears when people are in their teens or 20s. Sometimes, however, friends and families of people with a milder form of bipolar disorder — one that does not induce psychotic behavior — can mistake their condition for depression, Payne said. People who experience milder manic episodes — called hypomania — can seem energetic and productive, rather than deranged.

It’s also common for people with mental illness to suffer from multiple conditions, such as bipolar disorder and panic disorder, Lieberman said. A proportion of people with mental illness also suffer from substance abuse, as well, sometimes “self-medicating” to ease their moods.

Although drugs such as lithium can effectively treat bipolar disorders, some people with the condition are reluctant to use the medication because they feel it dulls their creativity and can cause side effects, Payne said.

Although mental illness can be life-threatening, many people with depression or bipolar disorder lead successful lives. Actresses Carrie Fisher and Margot Kidder spoke openly about coping with bipolar disorder. Pop stars Mariah Carey and Demi Lovato also have acknowledged having bipolar disorder.

Payne said she doesn’t hide her daughter’s bipolar diagnosis. Her daughter has been hospitalized at the hospital where she works. But her daughter is also a successful college student, who earns straight A’s and wins awards for her poetry.

“Suicide is not an acceptable outcome for depression,” Lieberman said.

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Liz Szabo, Kaiser Health News, contributed to this report. Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.